| Doctor Name: | MR. KENT JOSEPH FAIRCHILD |
| NPI Number: | 1104054410 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.N. |
| License Number: | 088834 |
| Business Practice Address: | 19 Madera Ct Kenner, LA - 700653140 |
| Business Phone Number: | 5044603271 |
| Business Fax Number: | |
| Mailing Address: | 19 Madera Ct, KENNER |
| State: | LA |
| Postal Code: | 700653140 |
| Phone Number: | 5044603271 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2009 |
| NPI Last Update Date: | 06/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | 088834 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |